HEENT Review Qs

Which of the following actions/response are included in the Near Reaction Test? A- Convergence and Consensual light response B- Divergence and Accommodation C- Convergence and Blink response D- Accommodation and Convergence

D- Accommodation and Convergence

Which of the following CN is being assessed based on the following description: The patient keeps his eyes closed and responds, saying "yes" each time he feels the sensation of cotton touching his upper, mid, and lower face. A- CN V (motor) B- CN VII (motor) C- CN I (sensory) D- CN V (sensory)

D- CN V (sensory)

Which test compares air conduction to bone conduction to assess hearing acuity? A- Whisper test B- Rhinne test C- Weber test D- Rinne test

B- Rhinne test

20/200 visual acuity means the patient positioned at 20 feet can read a print that a person with normal vision could read standing at 200 feet. A True B False

A True

What is the distance at which you should mount a well lit Snellen Eye chart from the patient when assessing their visual acuity? A- 20 feet B- 14 inches C- 14 feet D- 20 inches

A- 20 feet

Which of the following information should be included when documenting visual acuity? A Corrected/ uncorrected B Height of the patient C Refractory error D Color of the iris

A- Corrected/ uncorrected

The clinician shines light in the eye directly from the temoporal side to perform the Iris Shadow test. Which of the following is a abnormal finding? A- Crescentric shadow is casted on the medial side of the iris B- No shadow is casted and the iris is visualized completly C- White opaque spots are seen on the cornea and iris D- There is a marked difference in the diameter of the pupils

A- Crescentric shadow is casted on the medial side of the iris

Most appropriate question to ask before you palpate the external nose, ask the patient ... A-Have you had any facial trauma? B-Any changes in sense of smell? C- Do you breathe through your mouth? D- Do you have a runny nose?

A- Have you had any facial trauma?

A 78 year hold male presents with severe vertigo. He complains of dizziness and reports he is unable to stand. How can you access his visual acuity at the bedside? A Hold the hand-held card at 14 inches B Hold the Ishihara plates at 14 inches C Hold the Rosenbaum card at 20 feet D Ask the patient to stand for the test

A- Hold the hand-held card at 14 inches

What should you note when you are inspecting the head and face? A Size, symmetry, appearance, facial expression, and visible deformities B Size, symmetry,appearance, aesthetic, facial makeup, edema, and masses C Size, eye blinking, facial hair, length of eyelashes, and shape of the eyebrows D Size, moles, facial gelasins, facial expression, and any obvious deformities E Size, symmetry, tenderness, erythema, edema, masses, texture, and color

A- Size, symmetry, appearance, facial expression, and visible deformities

Which of the following ducts carry secretions from the Parotid gland? A- Stensen's duct B- Wharton's duct C- Ludwig's duct D- Wilson's duct

A- Stensen's duct

You are inspecting the thyroid gland. Which of the following is a normal finding? A- The thyroid cartilage, cricoid cartilage and the thyroid gland all rise with swallowing B- The thyroid cartilage, cricoid cartilage, and the thyroid gland fall with swallowing C- The trachea, nasal cartilage, uvula, and the thyroid gland fall with swallowing D- Masseter and temporalis muscles contract and thyroid gland rises with swallowing E- Protrusion of the tongue causes the thyroglossal duct cyst to move upwards

A- The thyroid cartilage, cricoid cartilage and the thyroid gland all rise with swallowing

This is an Ishihara Color Plate. It is used to identify color blindness. A- True B- False Findings of inflammation noted on inspection of the regions of the lacrimal gland and sac can support the diagnosis of Dacryocystitis. A-True B- False

A- True

Tumbling E-charts, Allen chart, and HOTV charts can be used to assess the patient's visual acuity? A-True B- False

A-True

B/L pupil size 6 mm A- Miosis B- Aniscoria C- Mydriasis D- Normal

C- Mydriasis

Which of the following is the most appropriate distance at which you will have your patient stand when you are assessing their visual acuity using the Snellen chart? A 20 inches B 20 feet C 14 inches D 14 feet

B- 20 feet

When assessing the Temporomandibular joint (TMJ) the examiner should A- Ask the patient to clench their teeth as the examiner palpates over the Masseter and Temporalis muscles B- Ask the patient to open their mouth and move the jaw from side to side to assess the ROM and palpate the TMJ joint for tenderness C- Ask the patient to puff their cheeks while the examine palpates the TMJ for tenderness D- Ask the patient to protrude the tongue, move it side-to side, palpate the TMJ for popping, crepitus, and clicking

B- Ask the patient to open their mouth and move the jaw from side to side to assess the ROM and palpate the TMJ joint for tenderness

Visual field defects are noted on the Confrontation test -Static wiggle test. The patient should be referred to an ophthalmologist for... A- Correction of refraction error B- Automated perimetry test C- Exophthalmometry test D- Direct ophthalmoscopic exam E- Cover/uncover test

B- Automated perimetry test

Which of the following cranial nerve can be assessed with the Visual fields confrontation test? A- CN III B- CN II C- CN V D- CN IV E- CN VI

B- CN II

Upon evaluating a patient, you note asymmetry of the face at rest and as the patient is talking. There is no wrinkles on the left side of the forehead, he is unable to close his left eye tightly, and there is drooping of the left lips and lower face when the patient smiles and frowns. The patient is able to detect the two odors presented to him suggesting intact sense of smell. There is no weakness in the extremities and no other neurologic deficits. His gait and balance is unremarkable. Which of the following cranial nerves (CN) is most likely involved based on the findings? A-CN I B- CN VII C- CN VIII D- CN V

B- CN VII

The findings of asymmetry of the corneal light reflection (Hirschberg test) suggest... A- Impairment of both Oculomotor nerves B- Deviation from the normal ocular alignment C- Abnormal direct and consensual light reaction D- Weakness in the inferior rectus muscle

B- Deviation from the normal ocular alignment

When using a traditional direct ophthalmoscope you should.. A- Brighten the room lights, use the right hand, right eye, to examine patient's right eye B- Dim the lights and use the right hand, right eye, to examine patient's right eye C- Dim the lights and use a Redfree light to examine the Optic cup and the disk D- Dim the lights and use your preferred hand and eye to examine patient's right eye

B- Dim the lights and use the right hand, right eye, to examine patient's right eye

The clinician notes proptosis as she is inspecting the eyes. Which of the following test can confirm the exam finding? A- Automated Perimetry test B- Exophthalmometry test C- Cover/uncover test D- Static finger wiggle test

B- Exophthalmometry test

Stand about two feet directly in front of the patient. Shine light into the eyes at the midline and ask the patient to look at the light. Note the light reflection. A- Corneal reflex test B- Hirschberg test C- Pupillary light response D- Extraocular muscle test

B- Hirschberg test

Gently pull the lower eyelids to inspect... A- Pupillary direct response B- Inspect the sclera and conjunctiva C- Inspect the eyebrow hair distribution D- Palpate the lacrimal gland

B- Inspect the sclera and conjunctiva

A patient is treated for acute dacryocystitis based on the HPI and physical exam findings. Which of the following structures were examined to support the diagnosis? A- Inspection of the eyelids, cornea, skull, and nose B- Inspection of the lacrimal sac and the lacrimal gland C- Inspection of the eyebrows for hair distribution and scaliness D- Inspection of the floor of the mouth and the temporomandibular joint

B- Inspection of the lacrimal sac and the lacrimal gland

Which of the following eye muscle cause the eye abduction? A- Medial rectus B- Lateral rectus C- Inferior oblique D- Superior rectus E- Inferior rectus

B- Lateral rectus

Which of the following describes the steps for performing the Corneal Reflex? A- Clench the teeth and palpate the Masseter and Temporalis muscles B- Lightly touch the cotton wisp to the lateral edge of the cornea C- Lightly touch the wisp of cotton over the upper, middle, and lower face D- Move a 5-mm red-topped pin inward to compare the patient's vision to examiner's

B- Lightly touch the cotton wisp to the lateral edge of the cornea

Test for... A- May reveal abnormal pupillary light reaction B- May reveal ocular misalignment C- May reveal deficit in the CN II D- May reveal lens opacity

B- May reveal ocular misalignment

TMJ ROM A- Move the tongue up and down, side-to side, then up-and -down B- Open and close the mouth and then move in lateral motion C- Ask the patient to say "Ahh" note the rise of soft palate D- Ask the patient to hold water in their mouth then swalow, note the trachea

B- Open and close the mouth and then move in lateral motion

Performed to confirm... A- Ocular misalignment B- Proptosis/exophthalmos C- Extraocular muscles D- Pupillary size

B- Proptosis/exophthalmos

Which of the following test is the most appropriate to test the central visual acuity? A Static finger wiggle test B Snellen eye chart C Kinetic Red Target test D Corneal reflex test E Near reaction test

B- Snellen eye chart

Which of the following findings suggest normal tympanic membrane (TM) when examining the TM using pneumatic otoscopy? A- The TM moves outward as the air is introduced into the EAC. The TM moves inward when the air is removed from the EAC. B- The TM moves inward as the air is introduced into the EAC. The TM moves outward when the air is removed from the EAC C- The TM is immobile as the air is introduced into the EAC. The TM moves outward when the air is removed from the EAC D- The TM moves inward as the air is introduced into the EAC. The TM is immobile when the air is removed from the EAC E- The TM perforates when air is introduced into the EAC. The TM moves outward when air is removed from the EAC

B- The TM moves inward as the air is introduced into the EAC. The TM moves outward when the air is removed from the EAC

Which of the following findings suggest a normal fundus? A- The disc is elevated with blurred marking, flame hemorrhages, and attenuated arterioles B- The outline of the disc is clear, the central physiological cup is pale, and the retina is red-orange. C- The outline of the disc is clear, the central cup appears more than half size of the outer disc D- Dilated retinal veins, multiple new growing blood vessels, and scattered exudates across the retina

B- The outline of the disc is clear, the central physiological cup is pale, and the retina is red-orange.

Which of the following exam may suggest sinusitis? A- Upon palpating the TMJ you note: clicking, tenderness, popping B- Upon palpating the nasal bone you note signs of deviation and tenderness C-Upon palpating the frontal and maxillary sinuses uou note localized tenderness D- Upon palpating the Masseter and Temporalis muscles you note the strength and tone E- Upon palpating the parotid gland you note erythema, edema, and tenderness

B- Upon palpating the nasal bone you note signs of deviation and tenderness

Hand hygiene before and after performing an exam A Use a pea-sized amount of alcohol foam, rub both hands for 20 seconds B Use soap and water to wash the hands, wash both hands for 20 seconds C Use some scented alcohol sanitizer gel form, wash both hands for 20 seconds D Use golf-sized alcohol foam, wash, and wipe both hands for 20 seconds E Use water to wash both hands followed by alcohol foam for 20 seconds

B- Use soap and water to wash the hands, wash both hands for 20 seconds

Pupil size <3 mm A- Miosis B- Mydriasis C- Aniscoria D- Normal

B- Used to look at the vasculature closely

Red free light A- Used to look for corneal abrasions w/ fluorescein dye B- Used to look at the vasculature closely C- Used to look at the contour abnormalities of the cornea, lens, or retina D- Used to approximate the relative distance between the retinal lesion

B- Used to look at the vasculature closely

The stem of a vibrating tuning fork is placed on the patient's skull at an equal distance from each ear. The patient asked - where do you hear the sound louder- left, right, or both? Based on the description which of the following test is being performed? A- Rinne test B- Weber test C- Whisper test D- Finger rub test

B- Weber test

You ask the patient to follow your finger as you bring it towards his nose from a distance- 12-18 inches A- Pupillary light reaction; CN 2, 3 B- Corneal Reflex; CN 5,7 C- Near Reaction test; CN 3 D- EOM test; CN 3, 4, & 6

C- Near Reaction test; CN 3

Visual acuity is expressed as two numbers. Which of the following is most appropriate when explaining the visual acuity? A The first number indicates the distance at which normal eye can read the line B The second number indicates the distance of the patient from the chart C The first number indicates the distance of the patient from the chart D The second number indicates the patients uncorrected peripheral visual acuity E The first number indicates the patients corrected peripheral visual acuity

C The first number indicates the distance of the patient from the chart

When palpating the lymph nodes... A- Use the pads of the thumb and index fingers, press the lymph nodes gently moving the skin over the underlying tissue B- Ask the patient to point out to any enlarged lymph nodes, press the lymph nodes gently moving the skin over the underlying tissue C- Use the pads of the middle and index fingers, press the lymph nodes gently moving the skin over the underlying tissue D- Ask the patient to hyperextend their nexk, press the lymph nodes gently moving the skin over the underlying tissue

C Use the pads of the middle and index fingers, press the lymph nodes gently moving the skin over the underlying tissue

Which of the following test is appropriate when assessing the patients peripheral vision? A Perform the Near Reaction test B Read the Snellen chart C Visual fields by confrontation D Extraocular muscle test-"H" path E Corneal Reflex-Blink test

C Visual fields by confrontation

Hand-held card should be held at A- 14 feet B- 16 inches C- 14 inches D- 16 feet

C- 14 inches

Used to assess the cranial nerves... A- 5, 6, & 7 B- 2,3, & 6 C- 3, 4, & 6 D- 2, 4, & 6

C- 3, 4, & 6

Which of the following cranial nerves are tested when you draw an "H-Path" with your finger and have the patient follow it with their eyes without moving their head? A- 4, 6, and 5 B- 3, 4, and 7 C- 4, 3, and 6 D- 5, 7, and 6

C- 4, 3, and 6

Which one of the following is the most appropriate choice to test the patients nasal patency (left)? A- Use your index finger to occlude the patient's left nostril, then ask the patient to detect 2 different odors B- Ask the patient to use their index finger to occlude the right nostril, then ask the patient to detect 2 odors C- Ask the patient to use their index finger to occlude their left nostril, then ask the patient to breathe in with the unoccluded nostril D- Ask the patient to use their index finger to occlude their right nostril, then ask the patient to breathe in with the unoccluded nostril

C- Ask the patient to use their index finger to occlude their left nostril, then ask the patient to breathe in with the unoccluded nostril

Upon examining the thyroid gland, the clinician notes thyromegaly. Which of the following physical exam steps should be performed to further assess the thyroid gland? A- Order a stat MRI of the neck B- Order a CT neck with contrast C- Auscultate the thyroid gland D- Inspect the thyroid gland E- Order a fine needle aspiration

C- Auscultate the thyroid gland

Which one of the following correctly explains the following in the order listed- OU, OD, OS A- Both, left, right B- Left, both, left C- Both, right, left D- Right, left, both

C- Both, right, left

The clinician ask the patient to open the mouth wide by saying "AHH" then gently touches the posterior pharyngeal wall with a cotton tip applicator. The patient gags and the clinician notes the elevation of soft palate bilaterally. Which of the following cranial nerve is being assessed with the above test? A- CN IX and CN XI B- CN X and CN XII C- CN IX and CN X D- CN VII and CN IX E- CN VI and CN X

C- CN IX and CN X

Open your mouth say "AHHH" and gag reflex help assess the cranial nerves... A- CN IX and XI B- CN X and XII C- CN IX and X D- CN V and X

C- CN IX and X

Assessing the tongue is midline followed by an assessment of the tongue movement - up, down, and side-to-side followed by test to check the tongue in cheek strength helps assess... A- CN X B- CN IX C- CN XII D- CN XI

C- CN XII

Which of the following is the most appprotiate technique when examining the ears? A- Child: Pull the auricle posteriorly and superiorly B- Adult: Pull the auricle posteriorly and inferiorly C- Child: Pull the auricle posteriorly and inferiorly D- Adult: Pull the auricle superiorly and inferiorly

C- Child: Pull the auricle posteriorly and inferiorly

To test the sense of smell (left) A- Close both eyes, use your index finger to occlude patients left nostril, detect the 2 odors one at a time B- Close both eyes, use the index fingers to occlude both nostrils, detect the 2 odors one at a time C- Close both eyes, use your index finger to occlude patients right nostril, detect the 2 odors one at a time D- Close both eye, use the index finger to occlude the right nostril, take a deep breathe in

C- Close both eyes, use your index finger to occlude patients right nostril, detect the 2 odors one at a time

A- Corneal Reflex test; CN II & III B- Pupillary light reaction; CN II & III C- Corneal Reflex test; CN V & VII D- Pupillary light reaction; CN V & VII

C- Corneal Reflex test; CN V & VII

Test for Strabismus A- Pupillary light response B- Corneal Reflex test C- Cover-uncover test D- Near Reaction test

C- Cover-uncover test

Which of the following findings suggest aniscoria? A- Constriction of both pupils B- Dilation of both pupils C- Difference in the pupillary size D- Loss of red-light reflex

C- Difference in the pupillary size

A 26-year-old female is transported to the emergency room as she reports inability to open her mouth (trismus), pain, and swelling over the lower jaw and neck. On physical examination, the patient is in respiratory distress, appears toxic, febrile-101.8 F, tacycardic at 128 bpm, along with elevated BP 148/92 mmHg. The clinician suspects Ludwig's angina due to exam findings of tenderness over the floor of the mouth along with copious purulent discharge at the second right molar. Which salivary glands and structures are likely to be involved in the described case? A- Sublingual, submandibular, and Parotid gland B- Frontal and Maxillary sinuses and Sublingual gland C- Floor of the mouth, Sublingual and Submandibular gland D- Sternocelidomastoid, temporomandibular joint, and trachea

C- Floor of the mouth, Sublingual and Submandibular gland

Which of the following muscle causes the eye adduction? A- Lateral Rectus B- Inferior Oblique C- Medial Rectus D- Superior Rectus

C- Medial Rectus

A patient returns to the clinic for a follow up visit after being treated for left acute otitis media. On exam, the TM appears pinkish gray-colored, translucent, and in neutral position. The pneumatic otoscopy reveals mobility of the TM. Which of the following is supported based on the exam findings? A- Retracted tympanic membrane B- Bulging Tympanic membrane C- Normal tympanic membrane D- Perforated tympanic membrane

C- Normal tympanic membrane

The inspection of the patient's lens (above image) suggest A- Concave lens B- Convex lens C- Opaque lens D- Abnormal lens curvature

C- Opaque lens

Which of the following should be performed to assess the Facial nerve (motor)? A- Ask the patient to swallow water, see the thyroid cartilage and gland rise B- Clench the teeth then palpate the Masseter and Temporalis muscles C- Raise the eyebrows, look at the wrinkles on both sides of the forehead D- Check light touch and sharp pain sensations over the Masseter and Temporalis muscles

C- Raise the eyebrows, look at the wrinkles on both sides of the forehead

To test the acuity of central vision you will use... A- Cover-uncover test B- Corneal Reflex test C- Snellen chart D- Near reaction test E- Kinetic Red target test

C- Snellen chart

You position yourself about an arms-length from the patient. You close one eye and ask the patient to close the opposite eye. You place your hands about 2 feet apart out of the patient's view, lateral to the patient's ear. You bring your finger from the right visual field of vision until it is recognized. You test each quadrant. A- Kinetic Red Target test, CN II, Peripheral visual acuity B- Extraocular muscle test, CN III, Peripheral visual acuity C- Static finger wiggle test, CN III, Peripheral visual acuity D- Static finger wiggle test, CN II, Peripheral visual acuity

C- Static finger wiggle test, CN III, Peripheral visual acuity

When examining the nose, ask the patient to... A-Look down to their chin, then insert the speculum gently B- Pull on the ala of the nose, insert the speculum gently C- Tilt the head slightly, insert the speculum gently D- Exhale through the nose, insert the speculum gently E- Rinse the nose well, insert the speculum gently

C- Tilt the head slightly, insert the speculum gently

Which of the following is the most appropriate light setting when performing a direct ophthalmoscopy exam on a patient whose pupils are dilated with mydriatic drops like Cyclopentolate? A- Use the small aperture B- Use the medium aperture C- Use the large aperture D- Use the Red-free light

C- Use the large aperture

To test the peipheral visual acuity A- Corneal reflex (blink) test B- Draw the "H-path" EOM test C- Visual fields by confrontation

C- Visual fields by confrontation

Static Wiggle test A-CN I, Peripheral visual acuity B-CN II, Central visual acuity C-CN II, Peripheral visual acuity D-CN III, Central visual acuity

C-CN II, Peripheral visual acuity

When inspecting the nasal mucosa you should note... A- Size of polyps in the superior turbinate, olfactory bulb, erythema, and edema B- Size, shape, number of peiercing, septum deviation, tenderness, and edema C- Inferior turbinates, olfactory epithelium, asymmetry, and boggy pale color D- Color, presence of discharge, edema, erythema, and presence of foreign body

D- Color, presence of discharge, edema, erythema, and presence of foreign body

Performed 1st when evaluating a patient A Walking in the room with confidence B Collecting a thorough medical history C Introduce tools needed for assessment D Introduce yourself along with your role E Inquire about the reason for the visit

D- Introduce yourself along with your role

Shine light directly from the temporal side to assess whether you can see the entire iris without a shadow. A- Corneal Reflex test B- Cover-uncover test C- Hirschberg test D- Iris Shadow test

D- Iris Shadow test

Which of the following exam will provide most information if the patient has any tenderness? A Auscultation B Inspection C Observation D Palpation E Discussion

D- Palpation

To assess the Hypoglossal nerve, you will ask the patient to... A- Raise both eyebrows and look at the forehead for symmetrical furrows, close eyes tightly, smile, frown, puff your cheeks B- Open and close the mouth and then move it in the side to side motion C- Check for sensation, light and sharp in various areas of the face-upper, mid, and lower face D- Protrude the tongue, move it up, down, and to the sides, pusg against the cheeks, dislodge with your fingers

D- Protrude the tongue, move it up, down, and to the sides, push against the cheeks, dislodge with your fingers

Weber test A- Compares air conduction to bone conduction B- The tuning fork is placed on the mastoid process then left in front of the ear C-The tuning fork is placed in front of the ear and then on the mastoid process D- Records the lateralization of the sounds

D- Records the lateralization of the sounds

Auditory acuity can be tested with... A- Corneal reflex test B- Stensen' test C- Near Reaction test D- Rinne test E- Webster test

D- Rinne test

When palpating the cervical lymph nodes, it is acceptable to palpate most of them simultaneouly on both sides. Which of the following lymph nodes should be palpated with one hand while bracing the top of the head with the other? A- Postauricular B- Occipital C- Submandibular D- Submental E- Sublingual

D- Submental

Which one of the following is the most appropriate statement when explaining the findings of visual acuity 20/20? A- The 1st number indicates the patient's peripheral visual acuity B- The 2nd number indicates the distances of the patient from the chart, i.e 20 inches C- The 1st number indicates the distance at which a normal eye can read the line, i.e 20 feet D- The 1st number indicates the distance of the patient from the chart, i.e 20 feet E- The 2nd number indicates the patients peripheral visual acuity when wiggling fingers inward from 2 feet

D- The 1st number indicates the distance of the patient from the chart, i.e 20 feet

Which of the following is most appropriate when performing the Static Wiggle test -Visual fields? The clinician stands in front of the patient about an arms-length... A- The clinician closes the right eye and ask the patient to close their right eye; move the fingers-start laterally at 2ft bring them to the central view B- The clinician draws a "H" with the finger and ask the patient to follow the finger with their eyes; assess the extraocular muscles with the eye movements C- The clinician closes the right eye and ask the patient to close their left eye; the clinician moves a red-topped pin inward from beyond the boundary of each qaudrant D- The clinician closes the right eye and ask the patient to close their left eye; the clinician moves the fingers by starting laterally at 2ft then bringing them to the central view

D- The clinician closes the right eye and ask the patient to close their left eye; the clinician moves the fingers by starting laterally at 2ft then bringing them to the central view

The clinician assessing the patient's hearing stands about 2 ft behind the patient and instructs the patient to occlude one ear. The clinician whispers a combination of numbers and alphabets and ask the patient to repeat it. Which of the following cranial nerves is being assessed based on the description? A- Whisper test, CN VII B- Weber test, CN VIII C- Rinne test, CN VII D- Whisper test, CN VIII

D- Whisper test, CN VIII

#1, #3, #5 #7 & 9 A- Preauricular, submental, postauricular, superficial posterior cervical, and anterior cervical lymph nodes B- Postauricular, submental, preauricular, superficial anterior cervical, and posterior cervical lymph nodes C- Preauricular, submental, postauricular, superficial anterior cervical, and posterior cervical lymph nodes D-Preauricular, submandibular, postauricular, superficial anterior cervical , and posterior cervical lymph nodes

D-Preauricular, submandibular, postauricular, superficial anterior cervical , and posterior cervical lymph nodes